Predictive Value Of Geriatric Nutritional Risk Index On Clinical Outcomes In Patients With Advanced Pancreatic Cancer

Background and PurposeThe Geriatric Nutritional Risk Index(GNRI)is a simple and well-established nutritional assessment tool that is an important prognostic factor for various cancers.However,the function of GNRI in predicting clinical outcomes in patients with advanced pancreatic cancer has not been investigated.The aim of this study was to explore the association between GNRI and the prognosis of patients with advanced pancreatic cancer.MethodsThe clinical data of 515 advanced pancreatic cancer patients first diagnosed at the Harbin Medical University Cancer Hospital from January 2008 to August 2018 were retrospectively collected.All patients were randomized 1:1 into experimental and validation sets.Optimal cutoffs were obtained via R;Cox univariate and multivariate regression were used to analyze the factors affecting the prognosis of patients in the experimental set and validation set;the median survival time was estimated via Kaplan Meier method.Subgroup analyses were performed separately for age and treatment modality,and P < 0.05 was considered statistically significant.ResultsIn the total patients,the 6-month survival rates in the high GNRI(GNRI>92.1)and low GNRI(GNRI<92.1)groups were 71%(95%CI: 61-75)and 26%(95%CI:19-35),respectively.The Cox multivariate analysis showed in the experimental set(HR: 0.42,95%CI: 0.31-0.58;P<0.001)and validation set(HR:0.43,95%CI:(0.28-0.66);P<0.001),GNRI>92.1 was found to be a protective factor for advanced pancreatic cancer survival,and its survival was superior to that of the GNRI<92.1 group.GNRI,liver metastasis status,and treatment modality were independent prognostic factors in patients with advanced pancreatic cancer(P > 0.05).The combined indicator of GNRI and liver metastasis could better predict patients’ overall survival.Subgroup analysis showed that GNRI>92.1 was a better prognostic factor in both elderly and non-elderly patients than patients with GNRI<92.1;GNRI and the combined index of GNRI and liver metastasis status were not significantly predictive in patients undergoing palliative surgery.ConclusionsGNRI is a reliable indicator to evaluate the prognosis of advanced pancreatic cancer,and patients with high GNRI have a longer survival than those with low GNRI.The combined index of GNRI and liver metastasis status could better predict overall survival,but the combined index of GNRI and GNRI and liver metastasis status could not predict the prognosis of advanced pancreatic cancer patients undergoing palliative surgery.